Health care survival in the future: Who is poised to take the lead?

What will it take to succeed in the health care during the next decade? Who is going to survive and who won’t? And who is positioning themselves to take on the role of “general contractor” as a new integrated model of business is set to take center stage?

Former Utah Gov. Michael O. Leavitt posed those questions to dozens of health care professionals gathered Wednesday at the University of Utah’s Rice Eccles Stadium for the start of a two-day symposium, “Collaboration in the New Landscape of Health Reform.”

Leavitt—who in addition to leading Utah from 1993 to 2003 served under former President George W. Bush as administrator of the Environmental Protection Agency and Secretary of Health and Human Services—urged those on the front lines of health care transformation to think about an action plan for the future.

“We’ve got make an analysis of our own situation,” Leavitt told health care leaders at the symposium. “This [health care reform] is not being driven by Obamacare, it’s being driven by economic reality. We have to lead here; we have to change in order to prosper.”

Leavitt guided the conversation on how to think about health care reform by presenting those in the audience with a scenario. He asked them to imagine they were part of an investment committee from a large investment firm seeking to enter the health care sector. He challenged the theoretical committee to decide which candidate to invest in based on how smooth a transition each could make from a fee-for-service business model to the philosophy of population health management.

Leavitt’s committee then listened to four potential candidates vying to become general contractor of the investment committee’s health care business. The examples included a group of physicians from a multi-specialty clinic; a hospital system; an insurance company and a “strategic aggregator” from another outside entity.

The committee evaluated each candidate using seven-part criteria to see which option might be the most effective for revamping the health care business model. Seven questions in the evaluation process included: Which candidate could change patient behavior? Which had a solid brand? Which had sufficient capital? Which had an ability to aggregate lives? Which had the competency for risk management? Which had a clinical footprint to bring lives together? And which had the collaborative IQ to make them the ideal candidate to take the helm of a health care system?

The answers to those questions soon made it clear that there wasn’t a sole candidate equipped to take on the job.

“What we realize is that no one has all of those characteristics,” Leavitt said. “So suddenly we see that no one has all the characterizes and we’re an investment fund, what is the logical thing to do to form an investment? We can bring them together. We can merge; we can create alliances.”

Forming those alliances is important as health care organizations figure out their next move for the future, Leavitt said, after completing the scenario with the audience.

Leavitt currently heads Leavitt Partner, a consulting firm that advises clients in the health care and food safety sectors. He specializes in helping state implement the Patient Protection and Affordable Care Act, more commonly known as ObamaCare.

Changes in health care law have been at the forefront of health care reform, including in Utah, which this month was also cast into the spotlight after receiving approval to become the first state to use a dual-model health insurance exchange.

The exchange allows the state and federal government to divide responsibilities and allows Utah to continue to run its existing health insurance marketplace for small businesses; a system that lets employees pick health care plans in an online exchange.

The federal government will run the state's individual exchange. The two marketplaces will operate independently of each other. Gov. Gary Herbert first requested this arrangement in February, and the two sides had been negotiating until reaching their recent agreement.

Leavitt addressed the issue of exchanges at Wednesday’s symposium, calling them a definite “part of the future.”

Sean Mulvihill, M.D. and CEO of the University of Utah Medical Group, said discussions like the conversation Leavitt started are essential for health care professionals trying to sort out a complex overhaul of the current healh care system.

“We’re all looking at the future and wondering what it holds for all of us. We’re trying to figure out how to adapt,” Mulvihill said.

“How can we work together to control our own future? We have the opportunity to redesign health care for our country. We know it’s not sustainable with where it’s at now … the people here are part of the solution on how we figure out how to do that.“

By: Melinda Rogers

Melinda Rogers is a communications specialist for University of Utah Health Sciences Office of Public Affairs.